Awareness and First Aid

This potentially life-threatening allergic reaction can develop within minutes of exposure to a trigger. Your quick response is critical. 

Anaphylactic shock is one of the most frightening medical emergencies you might face as a parent. “Anaphylaxis occurs when the immune system overreacts to a substance, such as pollen or nuts, that is usually harmless,” says Johan du Preez, Branch Manager at ER24 Potchefstroom. “Your child’s hypersensitive response releases a flood of chemicals like histamine, which can cause their body to go into shock.”

Unlike mild allergic reactions that can cause eye watering, itchy nose or a rash, anaphylaxis affects the whole body and can escalate quickly. “Blood pressure can drop suddenly, and airways narrow, making it difficult to breathe,” he adds.

Common triggers in children

Food allergies are particularly challenging because even tiny amounts can trigger severe reactions. Peanuts, tree nuts, milk, eggs, wheat, soy, fish, and shellfish are the most frequent culprits.

Insect stings: Bee, wasp and hornet stings can cause anaphylaxis in susceptible children. “Even those not known to be allergic to bees can have a quick and violent reaction, depending on the number of stings or amount of venom,” says Du Preez.

Medications: Antibiotics (particularly penicillin) and some non-steroidal anti-inflammatory drugs may trigger reactions.

Latex: Your child might be allergic to the latex found in balloons, rubber bands, gloves and other medical supplies. “These tend to cause a local allergic reaction, mostly resulting in redness, itching and mild swelling of the exposed skin,” says Du Preez. “However, if it causes facial swelling, particularly of the throat and tongue, it can be life-threatening.”

Exercise: Although very rare, some children may experience anaphylaxis when running or playing, referred to as exercise induced anaphylaxis. The exact cause is unknown, however it may be associated with certain external factors, such as eating certain foods or environmental factors.

Key warning signs of anaphylaxis

  • Skin reactions: Rashes, bumps, hives, flushing and swelling of the lips, tongue, or face are often the first visible signs.
  • Respiratory symptoms: Coughing, wheezing, shortness of breath, tightness in the chest or throat, or a sudden change in your child’s voice could indicate swelling in the throat around the vocal cords, says Du Preez.
  • Gastrointestinal issues: Babies and toddlers often have nausea, vomiting, abdominal cramps, and diarrhoea.
  • Cardiovascular signs: When blood pressure drops dramatically, your child might look pale and sweaty, feel dizzy or even lose consciousness.   
  • Behavioural changes: Your child might suddenly become irritable, anxious, or tired.

Every second counts

Anaphylaxis is always a medical emergency and requires immediate action. “Every child with known severe allergies should have an emergency action plan in place, and caregivers should have EpiPens (epinephrine auto-injectors) available and be trained in the use of it.” Du Preez says. “Using an EpiPen is not difficult, but doing so incorrectly could result in severe complications.” He adds that a playful way to remember the correct use is: “orange to the thigh, blue to the sky”. “The orange tip contains the small needle that is injected into the patient’s thigh. The blue cap is the safety cap that needs to be removed prior to use.”

When signs and symptoms appear, use the EpiPen and immediately call ER24 for real help, real fast. “Don’t wait to see if symptoms improve or worsen as every second counts,” says Du Preez. ER24 paramedics might give your child oxygen, or IV fluids and additional medication.

Long-term management and prevention of anaphylaxis

  • Work with your child’s doctor to identify specific triggers, such as shellfish or pet fur.
  • Check all food labels for nuts, eggs or other allergens.
  • Ensure your child’s teachers and caregivers know how to recognise allergic reactions and have EpiPens available to use.
  • If your child has severe allergies, consider a MedicAlert bracelet.
  • As your child gets older, help them take responsibility for their condition.

“While anaphylaxis is frightening, families can lead normal, active lives with proper precautions,” says Du Preez. “Many children outgrow certain allergies, particularly to milk and eggs. Stay informed and be prepared for emergencies. The key is preparation rather than panic.”